Closed-incision negative-pressure wound therapy (ciNPWT) to minimize wound-related complications in lower limb reconstruction after bone tumor resection: preliminary proof-of-concept study

• Published in: European journal of orthopaedic surgery & traumatology 2023-10, Vol.33 (7), p.2895-2902
• Main Authors: Soares do Brito, Joaquim, Esperança Martins, Miguel, Goes, Rodrigo, Spranger, André, Almeida, Paulo, Fernandes, Isabel, Portela, José
• Format: Article
• Language: English
• Subjects: Bone cancer; Medicine; Medicine & Public Health; Original Article; Surgical Orthopedics; Traumatic Surgery; Wound dehiscence
• ISSN: 1432-1068; 1633-8065; 1432-1068
• DOI: 10.1007/s00590-023-03501-5

Aims The purpose of this study was to compare the impact of postoperative closed-incision negative-pressure wound therapy (ciNPWT) and conventional dressings in wound-related complications after bone tumor resection and reconstruction. Patients and methods A total of 50 patients with bone tumors and clinical indication for wide resection and reconstruction were included and divided into two groups (A and B). Bone defect reconstructions were achieved with modular endoprosthesis or biologic techniques, mainly involving allografts with free vascularized fibula. Group A received ciNPWT, and Group B conventional dressings. Wound-related complications, including wound dehiscence, persistent wound leakage, surgical site infections (SSIs), and causes for surgical revision, were assessed. Results Nineteen patients were included in Group A and 31 in Group B. No significant differences were found between groups regarding epidemiologic and clinical presentation features, contrarily to reconstructive options, which were significantly different between both (Fisher = 10,100; p  = 0.005). Additionally, Group A presented lower wound dehiscence rate (0 vs. 19.4%; χ 2 (1)  = 4.179; p  = 0.041), SSI rate (0 vs. 19.4%; χ 2 (1)  = 4.179; p  = 0.041), and surgical revision rate (5.3% vs. 32.3%; χ 2 (1)  = 5.003; p  = 0.025) compared to Group B. Conclusions This is the first study reporting the impact of ciNPWT after bone tumor resection and reconstruction, and its results support a potential role for this technique in diminishing postoperative wound complications and SSIs. A multicentric randomized controlled trial may help clarify the role and impact of ciNPWT after bone tumor resection and reconstruction.